Persistent tic disorders (PTDs), including Tourette syndrome (TS), are neurodevelopmental disorders characterized by the presence of multiple motor and vocal tics for at least 1 year. Nearly 1.4 million Americans have PTDs, including TS. The prevalence is underreported because 50% of individuals who meet criteria for TS are suspected to be undiagnosed. The first clinical descriptions of TS were documented in the 1400s. It was not until 1885 that TS was formally characterized, and not until the 1960s that the understanding of TS shifted from psychological toward current neurobiologic theories. Although understanding of TS has expanded, there remain a lot of unknowns and stigma about the disorder. The goal of this study is to provide a brief historical perspective and review of the current knowledge of TS.
GerminianiFMMirandaAPFerenczyPMunhozRPTeiveHA. Tourette's syndrome: from demonic possession and psychoanalysis to the discovery of gene. Arq Neuropsiquiatr. 2012;70(7):547-549. doi:10.1590/s0004-282x2012000700014
2.
UedaKBlackKJ. A comprehensive review of tic disorders in children. J Clin Med. 2021;10(11):2479. doi:10.3390/jcm10112479
3.
ItardJM. Mémoire sur quelques fonctions involontaires des appareils de la locomotion, de la préhension et de la voix. Arch Gen Med. 1825;8:385-407.
4.
CavannaAESeriS. Georges Gilles de la Tourette and his legacy. Arch Med Health Sci. 2019;7(2):303-308. doi:10.4103/amhs.amhs_121_19
5.
Hughlings-JacksonJ. Clinical lectures and reports to the London. Hospital. 1884;1:452.
6.
CavannaAE. Introduction: the long and winding road to Tourette syndrome. In: CavannaAE, ed. Pharmacological Treatment of Tics. Cambridge University Press; 2020:1-8.
7.
RickardsHWoolfICavannaAE. “Trousseau's disease:” A description of the Gilles de la Tourette syndrome 12 years before 1885. Movement Disord. 2010;25(14):2285-2289. 10.1002/mds.23202
8.
GuinonG. Sur la maladie des tics convulsifs. Rev Med. 1886;6:50-80.
9.
RobertsonMMEapenV. Tourette's: syndrome, disorder or spectrum? Classificatory challenges and an appraisal of the DSM criteria. Asian J Psychiatr.2014;11:106-113. 10.1016/j.ajp.2014.05.010
10.
SeignotJN. [A case of tic of Gilles de la Tourette cured by R 1625]. Ann Med Psychol (Paris). 1961;119(1):578-579.
11.
ShapiroAKShapiroE. Treatment of Gilles de la Tourette's syndrome with haloperidol. Br J Psychiatry. 1968;114(508):345-350. doi:10.1192/bjp.114.508.345
12.
ShapiroAKShapiroESYoungJGFeinbergTE. Gilles de la Tourette syndrome. Raven Press; 1988.
13.
QuezadaJCoffmanKA. Current approaches and new developments in the pharmacological management of Tourette syndrome. CNS Drugs. 2018;32(1):33-45. doi:10.1007/s40263-017-0486-0
14.
TinkerSCBitskoRHDanielsonMLNewsomeKKaminskiJW. Estimating the number of people with Tourette syndrome and persistent tic disorder in the United States. Psychiat Res. 2022;314:114684. 10.1016/j.psychres.2022.114684
15.
KnightTSteevesTDayLLowerisonMJetteNPringsheimT. Prevalence of tic disorders: a systematic review and meta-analysis. Pediatr Neurol. 2012;47(2):77-90. doi:10.1016/j.pediatrneurol.2012.05.002
16.
BitskoRHClaussenAHLichsteinJ, et al. Mental health surveillance among children—United States, 2013-2019. MMWR Suppl. 2022;71(2):1-42. doi:10.15585/mmwr.su7102a1
17.
BlissJ. Sensory experiences of Gilles de la Tourette syndrome. Arch Gen Psychiatry. 1980;37(12):1343-1347. doi:10.1001/archpsyc.1980.01780250029002
18.
BanaschewskiTWoernerWRothenbergerA. Premonitory sensory phenomena and suppressibility of tics in Tourette syndrome: developmental aspects in children and adolescents. Dev Med Child Neurol. 2003;45(10):700-703. doi:10.1017/s0012162203001294
19.
BrandtVCBeckCSajinV, et al.Temporal relationship between premonitory urges and tics in Gilles de la Tourette syndrome. Cortex. 2016;77:24-37. doi:10.1016/j.cortex.2016.01.008
20.
LeckmanJFWalkerDECohenDJ. Premonitory urges in Tourette's syndrome. Am J Psychiatry. 1993;150(1):98-102. doi:10.1176/ajp.150.1.98
21.
EversRAvan de WeteringBJ. A treatment model for motor tics based on a specific tension-reduction technique. J Behav Ther Exp Psychiatry. 1994;25(3):255-260. doi:10.1016/0005-7916(94)90026-4
22.
CavannaAEBlackKJHallettMVoonV. Neurobiology of the premonitory urge in Tourette's syndrome: pathophysiology and treatment implications. J Neuropsychiatry Clin Neurosci. 2017;29(2):95-104. doi:10.1176/appi.neuropsych.16070141
23.
WohlgemuthJBWatsonKHGillKDIsaacsDA. Premonitory urge in tic disorders - a scoping review. Front Psychiatry. 2025;16:1504442. doi:10.3389/fpsyt.2025.1504442
24.
ComingsDEComingsBG. A controlled study of Tourette syndrome. I. Attention-deficit disorder, learning disorders, and school problems. Am J Hum Genet. 1987;41(5):701-741.
25.
HirschtrittMELeePCPaulsDL, et al.Lifetime prevalence, age of risk, and genetic relationships of comorbid psychiatric disorders in Tourette syndrome. JAMA Psychiatry. 2015;72(4):325-333. doi:10.1001/jamapsychiatry.2014.2650
26.
MartinoDGanosCPringsheimTM. Tourette syndrome and chronic tic disorders: the clinical spectrum beyond tics. Int Rev Neurobiol. 2017;134:1461-1490. doi:10.1016/bs.irn.2017.05.006
27.
FreemanRDFastDGBurdLKerbeshianJRobertsonMMSandorP. An international perspective on Tourette syndrome: selected findings from 3500 individuals in 22 countries. Dev Med Child Neurol.2000;42(7):436-447. Doi 10.1017/S0012162200000839
28.
CavannaAEServoSMonacoFRobertsonMM. The behavioral spectrum of Gilles de la Tourette syndrome. J Neuropsychiatry Clin Neurosci. 2009;21(1):13-23. doi:10.1176/jnp.2009.21.1.13
29.
American Psychiatric Association, Task Force on Nomenclature and Statistics, Committee on Nomenclature and Statistics. Diagnostic and Statistical Manual of Mental Disorders. 3rd ed. American Psychiatric Association; 1980, 494 p.
30.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed (DSM-5). American Psychiatric Association; 2013.
31.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision. American Psychiatric Association; 2022.
32.
SarchiotoMFreyJGanosC, et al.Diagnostic criteria for primary tic disorders: time for reappraisal. Movement Disord. 2024;39(8):1276-1281. 10.1002/mds.29868
33.
BlackKJGrossenSCArbuckleAL, et al.Diagnostic criteria for primary tic disorders: more reappraisal. Mov Disord. 2024;39(10):1902-1903. doi:10.1002/mds.30014
34.
MartindaleJMMinkJW. The rise of functional tic-like behaviors: what do the COVID-19 pandemic and social media have to do with it? A narrative review. Mini review. Front Pediatr.2022;10:863919. doi:10.3389/fped.2022.863919
35.
BarrJMangoldA. Call it as it is - why medical education should reconsider disease eponyms. Med Teach. 2024;46(8):1108-1110. doi:10.1080/0142159X.2023.2277133
36.
RaffaeleGMalikOAndersonS, et al.Tic-talk: voices on Tourette's labelling. Mov Disord Clin Pract. 2025;12(7):917-921. doi:10.1002/mdc3.70110
37.
DureLAlbinRL. Tourette syndrome and neurodiversity. Neurology. 2024;103(2):e209641. doi:10.1212/WNL.0000000000209641
38.
JonesDP. Tourette syndrome and cautious neurodiversity-disability categorization. Dev Med Child Neurol. 2024;66(6):816-817. doi:10.1111/dmcn.15833
39.
Ne'emanA. Tourette syndrome and Tourettic persons: internationalizing neurodiversity across diagnostic borders. Dev Med Child Neurol. 2023;65(11):1416-1417. doi:10.1111/dmcn.15746
40.
GraberARizzoM. Tourette syndrome: a catalyst for operationalizing neurodiversity. Neurology. 2024;103(2):e209572. doi:10.1212/wnl.0000000000209572
41.
BervoetsJBeljaarsDDe JaegherH. Letting Tourette's be: the importance of understanding lived experience in research and the clinic. Dev Med Child Neurol. 2023;65(11):1422-1428. doi:10.1111/dmcn.15545
42.
ColemanJMeliaY. Me, my tics and I: an exploration of self-identity and its implications for psychological wellbeing in young women with Tourette's syndrome. J Dev Phys Disabil. Published online May 12, 2023. doi:10.1007/s10882-023-09911-x
43.
BlackKJBlackERGreeneDJSchlaggarBL. Provisional tic disorder: what to tell parents when their child first starts ticcing. F1000Res. 2016;5:696. doi:10.12688/f1000research.8428.1
44.
GrossenSCArbuckleALBihunEC, et al.We've all been wrong about provisional tic disorder. Compr Psychiatry. 2024;134:152510. doi:10.1016/j.comppsych.2024.152510
45.
LiuFFanCYaoB, et al.Factors linked to prognosis in children with provisional tic disorder: a prospective cohort study. Eur J Pediatr. 2024;183(9):4009-4017. doi:10.1007/s00431-024-05651-y
46.
AlbinRL. Tourette syndrome: a disorder of the social decision-making network. Review. Brain. 2018;141(2):332-347. doi:10.1093/brain/awx204
47.
JankovicJMotorRH. Behavioral and pharmacologic findings in Tourette's syndrome. Can J Neurol Sci. 1987;14(S3):541-546. doi:10.1017/S0317167100038087
48.
GodarSCBortolatoM. What makes you tic? Translational approaches to study the role of stress and contextual triggers in Tourette syndrome. Neurosci Biobehav Rev.2017;76:123-133. 10.1016/j.neubiorev.2016.10.003
49.
BarberKEDingQEspilFM, et al.Contextual triggers and tic severity across life periods: a retrospective analysis in adults with tic disorders. Child Psychiat Hum Dev. Published online July 8, 2024. doi:10.1007/s10578-024-01733-y
50.
LeckmanJFZhangHPVitaleA, et al.Course of tic severity in Tourette syndrome: the first two decades. Pediatrics. 1998;102(1):14-19. DOI 10.1542/peds.102.1.14
51.
GrothC. Tourette syndrome in a longitudinal perspective. Clinical course of tics and comorbidities, coexisting psychopathologies, phenotypes and predictors. Dan Med J. 2018;65(4):B5465.
52.
BlochMHPetersonBSScahillL, et al.Adulthood outcome of tic and obsessive-compulsive symptom severity in children with Tourette syndrome. Arch Pediatr Adolesc Med. 2006;160(1):65-69. doi:10.1001/archpedi.160.1.65
53.
LichterDGFinneganSG. Influence of gender on Tourette syndrome beyond adolescence. Eur Psychiat. 2015;30(2):334-340. doi:10.1016/j.eurpsy.2014.07.003
54.
Mataix-ColsDIsomuraKBranderG, et al.Early-Life and family risk factors for tic disorder persistence into adulthood. Mov Disord. 2023;38(8):1419-1427. doi:10.1002/mds.29454
55.
YangKEssaANoriegaD, et al.Relationship between adverse childhood experiences and symptom severity in adult men with Tourette syndrome. J Psychiatr Res. 2022;155:252-259. doi:10.1016/j.jpsychires.2022.08.024
56.
GarrisJQuiggM. The female Tourette patient: sex differences in Tourette disorder. Neurosci Biobehav Rev.2021;129:261-268. 10.1016/j.neubiorev.2021.08.001
57.
LarshTRWuSWHuddlestonDAWhiteSLippsTDGilbertDL. Adolescent gender differences in tic- and non-tic-related impairments in Tourette syndrome. J Child Neurol. 2023;38(5):283-289. doi:10.1177/08830738231171959
58.
BitskoRHHolbrookJRVisserSN, et al.A national profile of Tourette syndrome, 2011-2012. J Dev Behav Pediatr. 2014;35(5):317-322. doi:10.1097/dbp.0000000000000065
59.
OlfsonMCrystalSGerhardT, et al.Patterns and correlates of tic disorder diagnoses in privately and publicly insured youth. J Am Acad Child Adolesc Psychiatry.2011;50(2):119-131. 10.1016/j.jaac.2010.11.009
60.
Dy-HollinsMECarrSJEssaA, et al.The challenge of examining social determinants of health in people living with Tourette syndrome. Pediatr Neurol. 2024;155:55-61. doi:10.1016/j.pediatrneurol.2024.02.008
FernandezTV. Genetics of Tourette syndrome. Psychiatr Clin North Am. 2025;48(1):1-13. doi:10.1016/j.psc.2024.08.002
63.
Mataix-ColsDIsomuraKPérez-VigilA, et al.Familial risks of Tourette syndrome and chronic tic disorders. A population-based cohort study. JAMA Psychiatry. 2015;72(8):787-793. doi:10.1001/jamapsychiatry.2015.0627
64.
ShapiroAKShapiroEFulopG. Pimozide treatment of tic and Tourette disorders. Pediatrics. 1987;79(6):1032-1039. doi:10.1542/peds.79.6.1032
SalleeFKohegyiEZhaoJ, et al.Randomized, double-blind, placebo-controlled trial demonstrates the efficacy and safety of oral aripiprazole for the treatment of Tourette's disorder in children and adolescents. J Child Adolesc Psychopharmacol. 2017;27(9):771-781. doi:10.1089/cap.2016.0026
67.
YooHKJoungYSLeeJS, et al.A multicenter, randomized, double-blind, placebo-controlled study of aripiprazole in children and adolescents with Tourette's disorder. J Clin Psychiatry. 2013;74(8):e772-e780. doi:10.4088/JCP.12m08189
68.
PringsheimTHoller-ManaganYOkunMS, et al.Comprehensive systematic review summary: treatment of tics in people with Tourette syndrome and chronic tic disorders. Neurology. 2019;92(19):907-915. doi:10.1212/WNL.0000000000007467
69.
PringsheimTOkunMSMuller-VahlK, et al.Practice guideline recommendations summary: treatment of tics in people with Tourette syndrome and chronic tic disorders. Neurology. 2019;92(19):896-906. doi:10.1212/WNL.0000000000007466
70.
RoessnerVEicheleHSternJS, et al.European clinical guidelines for Tourette syndrome and other tic disorders—version 2.0. Part III: pharmacological treatment. Eur Child Adolesc Psychiatry. 2022;31(3):425-441. doi:10.1007/s00787-021-01899-z
71.
Müller-VahlKRSzejkoNVerdellenC, et al.European clinical guidelines for Tourette syndrome and other tic disorders: summary statement. Eur Child Adolesc Psychiatry. 2022;31(3):377-382. doi:10.1007/s00787-021-01832-4
72.
SzejkoNRobinsonSHartmannA, et al.European clinical guidelines for Tourette syndrome and other tic disorders-version 2.0. Part I: assessment. Eur Child Adolesc Psychiatry. 2022;31(3):383-402. doi:10.1007/s00787-021-01842-2
73.
AndrénPJakubovskiEMurphyTL, et al.European clinical guidelines for Tourette syndrome and other tic disorders-version 2.0. Part II: psychological interventions. Eur Child Adolesc Psychiatry. 2022;31(3):403-423. doi:10.1007/s00787-021-01845-z
74.
GanosC. Clinical practice patterns in tic disorders among movement disorder society members. Tremor Other Hyperk. 2021;11(1):43. doi:10.5334/tohm.656
75.
MalatyIShinemanDHimleM. Tourette syndrome has substantial impact in childhood and adulthood as well. J Dev Behav Pediatr.2019;40(6):468-469. doi:10.1097/dbp.0000000000000699
76.
AzrinNHNunnRG. Habit-reversal: a method of eliminating nervous habits and tics. Behav Res Ther. 1973;11(4):619-628. doi:10.1016/0005-7967(73)90119-8
KatatoHMunizJALopez-ArvizuCMcGuireJF. Evidence-Based behavior therapy for Tourette syndrome. Psychiatric Clin North Am. 2025;48(1):77-89. 10.1016/j.psc.2024.08.007
79.
McGuireJFRickettsEJPiacentiniJMurphyTKStorchEALewinAB. Behavior therapy for tic disorders: an evidenced-based review and new directions for treatment research. Curr Dev Disord Rep. 2015;2(4):309-317. doi:10.1007/s40474-015-0063-5
80.
McGuireJFRickettsEJPiacentiniJMurphyTKStorchEALewinAB. Behavior therapy for tic disorders: an evidenced-based review and new directions for treatment research. Curr Dev Disord Rep.2015;2(4):309-317. doi:10.1007/s40474-015-0063-5
81.
PetersonALBlountTHVillarrealRRajJJMcGuireJF. Relaxation training with and without comprehensive behavioral intervention for tics for Tourette's disorder: a multiple baseline across participants consecutive case series.J Behav Ther Exp Psychiatry. 2022;74:101692. doi:10.1016/j.jbtep.2021.101692
82.
PiacentiniJWoodsDWScahillL, et al.Behavior therapy for children with Tourette disorder: a randomized controlled trial. JAMA. 2010;303(19):1929-1937. doi:10.1001/jama.2010.607
83.
WilhelmSPetersonALPiacentiniJ, et al.Randomized trial of behavior therapy for adults with Tourette syndrome. Arch Gen Psychiat. 2012;69(8):795-803. doi:10.1001/archgenpsychiatry.2011.1528
84.
McGuireJFPiacentiniJBrennanEA, et al.A meta-analysis of behavior therapy for Tourette syndrome. J Psychiatr Res. 2014;50:106-112. doi:10.1016/j.jpsychires.2013.12.009
85.
EspilFMWoodsDWSpechtMW, et al.Long-term outcomes of behavior therapy for youth with Tourette disorder. J Am Acad Child Adolesc Psychiatry.2022;61(6):764-771. 10.1016/j.jaac.2021.08.022
86.
FletcherJDimitropoulosGMartinoD, et al.Developing a provincial patient support network for children and families affected by Tourette syndrome and/or obsessive-compulsive disorder: results of a stakeholder consultation. Child Adolesc Psychiatry Ment Health. 2021;15(1):29. doi:10.1186/s13034-021-00383-5
87.
BhikramTElmaghrabyRAbi-JaoudeESandorP. An international survey of health care services available to patients with Tourette syndrome.Front Psychiatry.2021;12:621874. doi:10.3389/fpsyt.2021.621874
88.
MartindaleJMSarvaHMartinoD, et al.Study protocol: a cross-sectional survey of clinicians to identify barriers to clinical practice guideline implementation in the assessment and treatment of persistent tic disorders. PLoS One. 2023;18(7):e0288408. doi:10.1371/journal.pone.0288408
89.
CuencaJGlazebrookCKendallT, et al.Perceptions of treatment for tics among young people with Tourette syndrome and their parents: a mixed methods study. BMC Psychiatry. 2015;15(1):46. doi:10.1186/s12888-015-0430-0
90.
WoodsDWConeleaCAHimleMB. Behavior therapy for Tourette's disorder: utilization in a community sample and an emerging area of practice for psychologists. Prof Psychol: Res Pract. 2010;41(6):518-525. doi:10.1037/a0021709
91.
WolickiSBBitskoRHHolbrookJR, et al.Treatment use among children with Tourette syndrome living in the United States, 2014. Psychiatry Res. 2020;293:113400. doi:10.1016/j.psychres.2020.113400
92.
OudMde WinterLVermeulen-SmitE, et al.Effectiveness of CBT for children and adolescents with depression: a systematic review and meta-regression analysis. Eur Psychiatry. 2019;57:33-45. doi:10.1016/j.eurpsy.2018.12.008
93.
SigurvinsdóttirALJensínudóttirKBBaldvinsdóttirKDSmárasonOSkarphedinssonG. Effectiveness of cognitive behavioral therapy (CBT) for child and adolescent anxiety disorders across different CBT modalities and comparisons: a systematic review and meta-analysis. Nord J Psychiatry. 2020;74(3):168-180. doi:10.1080/08039488.2019.1686653
94.
WangYZZhangXHanXM. Efficacy of cognitive-behavioral therapy combined with habit reversal training on anxiety disorders in children with Tourette's syndrome. World J Psychiatry. 2024;14(7):999-1008. doi:10.5498/wjp.v14.i7.999
95.
StorchEAPerisTSDe NadaiA, et al.Little doubt that CBT works for pediatric OCD. J Am Acad Child Adolesc Psychiatry. 2020;59(7):785-787. doi:10.1016/j.jaac.2020.01.026
96.
UhreCFUhreVFLønfeldtNN, et al.Systematic review and meta-analysis: cognitive-behavioral therapy for obsessive-compulsive disorder in children and adolescents. J Am Acad Child Adolesc Psychiatry. 2020;59(1):64-77. doi:10.1016/j.jaac.2019.08.480
SzejkoNWorbeYHartmannA, et al.European clinical guidelines for Tourette syndrome and other tic disorders–version 2.0. Part IV: deep brain stimulation. Eur Child Adolesc Psychiatry. 2022;31(3):443-461. doi:10.1007/s00787-021-01881-9
99.
MartinoDDeebWJimenez-ShahedJ, et al.The 5 pillars in Tourette syndrome deep brain stimulation patient selection: present and future. Neurology. 2021;96(14):664-676. doi:10.1212/wnl.0000000000011704
100.
ZhangALiuTXuJ, et al.Efficacy of deep brain stimulation for Tourette syndrome and its comorbidities: a meta-analysis. Neurotherapeutics. 2024;21(4):e00360. doi:10.1016/j.neurot.2024.e00360
101.
BestRArseniev-KoehlerA. The stigma of diseases: Unequal burden, uneven decline. Am Sociol Rev. 2023;88(5):938–969. doi:10.1177/00031224231197436
102.
PringKMalliMHardyBW, et al.Reframing stigma in Tourette syndrome: an updated scoping review. Eur Child Adolesc Psychiatry. 2025;34(1):19-39. doi:10.1007/s00787-023-02332-3
StorchEAHanksCEMinkJW, et al.Suicidal thoughts and behaviors in children and adolescents with chronic tic disorders. Depress Anxiety. 2015;32(10):744-753. doi:10.1002/da.22357
106.
JohncoCMcGuireJFMcBrideNMMurphyTKLewinABStorchEA. Suicidal ideation in youth with tic disorders. J Affect Disord.2016;200:204-211. 10.1016/j.jad.2016.04.027
RickardsHPaschouPRizzoRSternJS. A brief history of the European Society for the Study of Tourette Syndrome. Behav Neurol. 2013;27(1):3-5. doi:10.3233/ben-120287
110.
ADA DA. Americans With Disabilities Act. Title II Public Services and Transportation. 1990.
111.
71 34 CFR Parts 300 and 301. Assistance to States for the Education of Children With Disabilities and Preschool Grants for Children With Disabilities (2006).
112.
ConeleaCABennettSHimleM, et al.Treating Tourette together: an agenda for patient-centered research focused on comprehensive behavioral intervention for tics. Behav Ther.2024;55(2):263-276. 10.1016/j.beth.2023.06.005
